Articles / 2007

End-of-life care and the agonizing choices often faced by dying patients and their loved ones is never an easy subject to discuss, privately or publicly.

The question of whether a physician should assist in hastening the death of a terminally ill patient by prescribing a lethal dose of medication when the patient requests it has been hotly debated in the state Legislature and across the nation.

Dr. Jim Hornstein, chairman of the Bioethics Committee at Community Memorial Hospital in Ventura, posed that question Wednesday to a local audience of more than 100 residents when he asked, "Should patients have a right to physician-assisted suicide, and should doctors have a duty to help them?"

Donna Kimura of Thousand Oaks, an educational administrator, disagreed. "It may be an ethical question for doctors, but not for me. We should have the right to choose," she said.

The divergent views highlighted the dividing line between many physicians and patients.

"Sixty percent of doctors are against it, and 60 percent of the public favors it," said Hornstein, who has practiced family medicine in Ventura since 1983. "Everyone wants compassion and dignity for the dying but have different ways of achieving it."

Most doctors can alleviate the pain of a terminal disease with properly prescribed and monitored care, along with a combination of support services that include psychological and spiritual help, said Dial.

"This whole debate arises out of a lack of understanding of appropriate end-of-life care," he said.

The majority of those at the meeting, which was part of Community Memorial's series of monthly public seminars, supported a patient's right to physician-assisted suicide not only to end unbearable pain but also to spare their families the anguish of watching them suffer.

"I don't want my kids to be tormented the way I was over my mother, who died of Alzheimer's disease," said Pat Lindley.

"If it happens to me, I want a choice in when I go."

But Sam Rinaldi, a network engineer, said, "From our appliances to our food, we've become a disposable society. Now we want to do that with human beings. We don't own our bodies. They belong to God."

Gil Deande, who favors physician-assisted suicide, replied, "I believe God created my body, but I've also been given a mind to make decisions with."

For many, it's an ethical and secular discussion. For others, religious tradition shapes their opinions.

The complexity of the issue, along with the possibility that California lawmakers might bring back for debate next year an assisted-suicide bill, is the reason Hornstein wants a public dialogue.

A doctor-prescribed, self-administered, lethal dose of medication is legal in Oregon, the only state thus far to enact such a law.

California legislators used that law as a model for Assembly Bill 374, which was sidelined in June.

Known as the California Compassionate Choices Act, the bill would allow patients with diagnoses of three months or less to live to obtain a lethal prescription, if they meet stringent criteria outlined in the proposed law, said Assemblyman Lloyd Levine, D-Van Nuys, co-author of the bill.

"The Oregon law has worked, and ours has even more safeguards in it. We're going to keep working on it until we get it done. The governor has said he's open to it," said Levine.

Assemblywoman Audra Strickland, R-Moorpark, said the bill lacks the necessary protections to prevent people from being coerced into physician-assisted suicide.

"I don't think the votes are there, and I'm against it on principle," she said.

Dial questioned the kind of message the passage of AB374 would send to the sick and elderly.

"When does the choice to end a life become a duty to die?"

Lauren Alexander, a hospice volunteer, said he came to the meeting opposing physician-assisted suicide but left supporting it.

"I've been with patients dying of prostate cancer, and so often death seemed like relief. We should get relief at the time of our choosing," said Alexander.